Broken Heart

By Christine Gorman

I had always asumed that a broken heart was just a metaphor, a cliche of country music and romance novels. So I was as surprised as anyone to learn last week that doctors now consider it a real medical event, one that can kill.

The news comes from a report published in the New England Journal of Medicine, in which physicians at Johns Hopkins described a group of 18 mostly older women and one man who developed serious heart problems after experiencing a sudden emotional shock, such as the death of a loved one, or, in the case of one 60-year-old woman, a surprise birthday party.

What surprised the doctors who examined these patients was that none of them had actually suffered a heart attack. Indeed, few had any signs of heart disease at all. Yet at least five of the 19--and perhaps more--would have died without treatment, according to Dr. Ilan Wittstein, the cardiologist who led the study.

What was going on? To get to the bottom of it, Wittstein and his colleagues measured the levels of catecholamines--the family of stress hormones that includes adrenalin--that their patients were producing. In each case they found high levels of stress hormones--up to 34 times as great as normal levels and two to three times as great as those typically seen during severe heart attacks.

It's still unclear whether the hormones caused the cardiac problems or were caused by them. Nor can doctors explain why women's hearts seem more vulnerable than men's. "Men typically produce higher levels of catecholamines in response to a stressful event than women do," Wittstein says. "So if you had to guess, you'd guess that men would have this problem more than women."

The good news about the condition doctors are calling the broken-heart syndrome is that it's reversible--provided the initial shock isn't too great. And repeat occurrences appear to be uncommon, no matter how many surprise birthday parties they throw you.